BACKGROUND: It has been said that anesthesia and surgery tend to increse 'stress hormone' followed by reduction of GFR and urine flow. We have been noticed a polyuria during mastoidectomy with anesthesia. We hypothesized that a reduction of ADH secretion related to operative procedure might be a cause of a transient polyuria. METHODS: In 41 patients who were in ASA class I, mean arterial pressure (MAP), heart rates (HR), temperature, central venous pressure (CVP) were measured at before induction, just before drilling with irrigation, 30 minutes and 60 minutes after drilling with irrigation, and on arrival in recovery room by groups (room temperatured irrigating fluid and warm fluid were used in group 1 and group 2) during procedures. In 7 of 41, blood samples for antidiuretic hormone (ADH) and plasma osmolalities (Posm) were withdrawn at the same time points. In all patients, fluid were administered with 4 ml/kg/hour throughout the procedures. RESULTS: In group 1, mean urine volume were 5.0 and 6.4 ml/min during anesthesia and drilling with irrigation that was significantly more than in group 2 (3.6 and 4.2 ml/min). In 7 patients, ADH concentration was decreased during surgery compared to pre-induction level, while the Posm were in normal ranges. None of the MAP, HR and CVP showed significant changes. ADH concentrations were not significantly correlated to Posm. CONCLUSIONS: We suggest that a reduction of ADH secretion may have a major role in transient polyuria during mastoidectomy, which might be related to the mechanism that; 1) lowered temperature of hypothalamo-pituitary system by cold irrigating fluid may induce a transient ischemic changes of pituitary gland, 2) absorption of hypoosmolar irrigating fluid to central circulation may reduce central osmotic pressure.
Absorption ; Anesthesia ; Anesthesia, General* ; Arterial Pressure ; Central Venous Pressure ; Heart Rate ; Humans ; Osmolar Concentration ; Osmotic Pressure ; Pituitary Gland ; Plasma* ; Polyuria ; Recovery Room ; Reference Values ; Surgical Procedures, Operative

We report a case of congenital vellus hamartoma, which consists of numerous matured vellus hair follicles and sebaceous glands. This patient is 4-month-old male with multiple, variable sized nodules on the right epicanthsl fold area since birth. Histopathologically, some of the infundibular portion of the vellus hair shows irregular and reticulated hyperplasia. There are numerous well-formed vellus hair follicles surrounded with thick fibrous sheath and some of them are associated with rudiment sebaceous glands.
Hair ; Hair Follicle ; Hamartoma* ; Humans ; Hyperplasia ; Infant ; Male ; Parturition ; Sebaceous Glands

According to the Mainz classification, renal cell carcinoma (RCC) consists of three subtypes: each has characteristic genetic alterations within the chromosomal or mitochondrial DNA. The three subtypes are: clear cell type, chromophil type, and chromophobe type. E-cadherin is a Ca++-dependent adhesion molecule which plays a major role in the maintenance of intercellular adhesion in epithelial tissues. In a normal kidney, E-cadherin is expressed in the distal tubule and the collecting duct, but not in the proximal tubule. We reclassified 110 cases of RCC according to mainz classification. Immunohistochemical staining for E-cadherin was done on twenty eight cases of RCC, including 18 cases of clear cell type, four cases of chromophil type, and six cases of chromophobe type. The results were as follows: 1) of the 110 cases of RCC, 96 cases (87.3%) were of clear cell type, four cases (3.6%) of chromophil type, and ten cases (9.1%) of chromophobe type, 2) there was no significant correlation between the nuclear grade and clinical stage according to each subtype, 3) E-cadherin expression showed a strong positive reaction along the cell membranes in all six cases of chromophobe type. The differential expression of E-cadherin in RCC may suggest that the chromophobe type may have different biologic characteristics from other types of RCC.
Cadherins* ; Carcinoma, Renal Cell* ; Cell Membrane ; Classification* ; DNA, Mitochondrial ; Immunohistochemistry ; Kidney ; Population Characteristics

No abstract available.
Antibodies* ; Coxiella burnetii* ; Coxiella* ; Korea* ; Prevalence* ; Q Fever*

Proliferating tumor is one of rare benign tumors of skin appendage. It is usually solitary, more common in women after the fourth decade of life, and is almost exclusively confined to the scalp and back of the neck. We report herein two cases of proliferating trichilemmal tumor which occurred not on the scalp but on unusual sites. In the first case a 28 year-old woman had a pedunculated reddish mass with verrucous surface measuring 1.5cm in diameter in the opening site of the left external auditory canal. Shave biopsy and electrodesiccation was done for the purpose of histopathologic study and treatment. In the second case a 13 year-old girl had a dome-shaped pink colored papule measuring 0.3cm in diameter on the left elbow joint area. Excision biopsy was done. No recurrence was observed during he follow up period of 28and 12 months respectively in both cases.
Adolescent ; Adult ; Biopsy ; Ear Canal ; Elbow Joint ; Female ; Follow-Up Studies ; Humans ; Neck ; Recurrence ; Scalp ; Skin

No abstract available.
Antibodies* ; Coxiella burnetii* ; Coxiella* ; Korea* ; Prevalence*

No abstract available.
Anetoderma* ; Granuloma Annulare* ; Granuloma*

Thirty-nine patients with pityrosporum folliculitis were investigated clinically and histopathologically. On clinical observation there were numerous, chronic, moderately itchy (64.1%), dome-shaped papules (89.7%) and pustules (66.7%). The most frequent sites of the lesions were the upper portion of the chest (76.9%) and back (56.4%). In biopsy specimens, abundant round and budding yeast cells were seen in a dilated hair follicle. The reptured follicle was observed in 19 specimen (48.7%). The accumulation on inflammatory cells were observed in or around the upper part of the follicle in all specimens. The effect of antimycotic treatment was excellent. After 4 weeks of treatment, 36 patients (92%) were cured and 3 (8%) had improved significantly. KOH/Parker Ink direct smear was done in 20 patients. Blue-colored round and budding yeast cells were observed under a light mcroscope in all patients. We suggest that pityrosporum folliculitis is a common disease of young and middle-aged Koreans.
Biopsy ; Folliculitis* ; Hair Follicle ; Humans ; Ink ; Malassezia* ; Saccharomycetales ; Thorax ; Yeasts

Spontaneous perirenal hematoma can occur during the course of a varied group of diseases. It is not a rare disease. The diagnosis is based on either the sudden or insidious onset of abdominal or flank pain, abdominal distention, the symptoms and signs of internal bleeding, and the appearance of a mass in either upper quadrant. The picture of the acute surgical condition of the abdomen is often seen. The treatment is surgery and prognosis depends upon the underlying disease, the degree of hemorrhage and the promptness of treatment. We experienced one case of spontaneous perirenal hematoma due to metastatic choriocarcinoma only to the perirenal fat, not renal parenchyme.
Abdomen ; Choriocarcinoma* ; Diagnosis ; Female ; Flank Pain ; Hematoma* ; Hemorrhage ; Pregnancy ; Prognosis ; Rare Diseases

We evalusted the magnetic resonance imaging (MRI) findings of the femoral heads in 20 normal and 45 abnormal patients. The bone marrow in the healthy adults consisted of a combination of hematopoietic and fatty marrow, which showed age-related dirtribation, that is the component of fatty marrow was increased and the marrow vascularity was dereased with age. Avascular necrosis (AVN) showed a decreased bone marrow signal within an normal appearing femoral head on T1 and T2-weighted images. In addition, we could see inhomogenous low signal intensity (31 cases), a ring of low intensity with central normal signal intensity (25cases), focal low signal intensity (12 cases), or a band of low signal intensity (4 cases). MRI findings were abnormal in 10 cases with normal radiographic findings as well as in all the cases with abnormal ones. In conclusion, MRI should be the choice of the imaging modality for the evaluation of early bone marrow chages of AVN.
Adult ; Bone Marrow ; Head* ; Humans ; Magnetic Resonance Imaging* ; Necrosis*